Abstract P884: Differences in Stroke Type and Stroke Risk Factors Between African Americans and Ghanaian Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Stroke Risk ◽  
Country Of Origin ◽  
Multivariate Regression Analysis ◽  
The United States ◽  
Rural Setting ◽  
Stroke Risk Factors ◽  
Ancestral Lineage ◽  
Stroke Type

Introduction: Ancestral lineage of many African Americans (AA) includes West African descent. Previous research has shown a higher prevalence of cardiovascular risk factors such as hypertension and diabetes mellitus (DM) in AA compared to other racial groups in the United States (US). Some have attributed these differences in the US population to ancestral lineage of the AA population. We sought to compare the stroke type and stroke risk factors between AA and Ghana, a country in West Africa. Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, stroke type and clinical factors. Results: Among the 5519 patients, the median age was 66 (IQR 45 - 87), 49% woman, 16% AA, 19% Ghanaian, and 66% non-Hispanic white. In the total population, 22% had an intracerebral hemorrhage, 69% ischemic stroke, and 9% subarachnoid hemorrhage. Compared to patients in the U.S., patients from Ghana were younger (OR 1.06, 1.05-1.06 95% CI); more likely female (OR 1.66, 1.0-1.97 95% CI), hypertensive (OR 8.87, 6.46-12.17 95%CI), and more likely to consume alcohol (OR 4.25, 3.32-5.44 95% CI). Ghanaians were less likely to have DM (OR 0.81, 0.66-0.99 95% CI), smoke (OR 0.10, 0.07-0.13 95% CI), and live in an urban vs rural setting (OR 0.84, 0.71-0.99 95% CI). Compared to AA specifically, Ghanaians were younger (OR 1.02, 1.01-1.03 95% CI); more likely female (OR 1.45, 1.15-1.81 95% CI), hypertensive (OR 4.66, 3.25-6.68 95%CI), more likely to consume alcohol (OR 3.68, 2.62-5.18 95% CI); less likely to have DM (OR 0.55, 0.43-0.71 95% CI), smoke (OR 0.13, 0.08-0.19 95% CI), and less likely live in an urban vs rural setting (OR 0.66, 0.53-0.82 95% CI). Conclusion: Significant differences were found between stroke risk factors (hypertension, DM, alcohol consumption, and smoking) and race as well as country of origin. Further study of social and environmental differences between groups may elucidate the differences in stroke risk factors between AA’s and West Africans.

Abstract P886: Differences in Medication Utilization for Secondary Stroke Prevention Between Ghanaian Stroke Patients and Stroke Patients in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
The United States ◽  
Rural Setting ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Stroke Risk Factors ◽  
Medication Utilization ◽  
Oral Agents

Introduction: Optimization of secondary stroke prevention is an essential part of stroke care globally. We sought to assess differences in medication utilization between African Americans (AA), Non-Hispanic Whites (NW), and Ghanaians in addition to effects related to location of residence (rural versus urban). Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, patient demographics, location of residence, stroke risk factors, and clinical management following stroke. Results: Of the 5519 patients studied, the median age was 66 (IQR 45 - 87), 16% were AA, 19% Ghanaian, 66% NW, and 51% were male. After controlling for age, sex, stroke type, and stroke risk factors, we found that in comparison to the AA and NW, patients from Ghana were more likely to be prescribed angiotensin converting enzyme (ACE) inhibitors (OR 1.42, 1.05-1.93 95% CI), angiotensin receptor blockers (ARB) (OR 18.36, 13.08-25.78 95% CI), calcium channel blockers (CCB) (OR 8.35, 6.30-11.08 95% CI), statin (OR 3.26, 2.26-4.59 95% CI), anti-diabetic oral agents (OR 7.18, 4.21-12.27 95% CI); less likely to be prescribed anticoagulant (OR 0.22, 0.12-0.40 95% CI), beta blockers (BB) (OR 0.15, 0.11-0.21 95% CI), and insulin (OR 0.11, 0.06-0.20 95% CI). In comparison to AA, Ghanaians were more likely to be prescribed statin (OR 3.06, 1.93-4.86 95% CI), ARBs (OR 22.87, 13.85-37.79 95% CI), CCBs (OR 5.83, 3.94-8.62 95% CI), anti-diabetic oral agents (OR 8.89, 4.25-18.59 95% CI); less likely to live in an urban vs rural setting (OR 0.64, 0.46-0.89 95% CI), be prescribed anticoagulant (OR 0.28, 0.14-0.55 95% CI), BBs (OR 0.13, 0.0.09-0.19 95% CI), and insulin (OR 0.11, 0.05-0.23 95% CI). Conclusion: In conclusion, we found significant differences in the prevalence of medications prescribed for stroke prevention between Ghana and the U.S. Further research is needed to determine if these differences result in consequential differences in stroke reoccurrence between these populations.

scholarly journals Stroke knowledge among middle and high school students

2019 ◽  
Vol 47 (9) ◽  
pp. 4230-4241
Author(s):  
Abdullah B. Umar ◽  
Tracy J. Koehler ◽  
Reian Zhang ◽  
Veronica Gilbert ◽  
Muhammad U. Farooq ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
High School ◽  
High School Students ◽  
Stroke Risk ◽  
The United States ◽  
Medical Emergency ◽  
School Students ◽  
Stroke Risk Factors ◽  
Stroke Awareness

Objective To determine the awareness of stroke symptoms and risk factors in middle and high school students at a single institution. Methods An 11-question multiple-choice stroke awareness survey was administered to students in grades 7 to 12 at City High Middle School in Grand Rapids, Michigan, United States. Summary statistics were calculated. Results A total of 603/608 surveys were analyzed. Only 8% of respondents correctly identified stroke as the fifth leading cause of death in the United States. Half (50.1%) recognized that a stroke occurred in the brain. Sixty-seven students (11.1%) correctly identified all 11 stroke risk factors. Only 5.1% correctly selected all four correct stroke symptoms. Two-thirds (64.5%) recognized stroke as an immediate medical emergency. Slightly more than half (55.9%) knew the acronym FAST (face, arms, speech, time). Conclusions Most students in our study were unaware of all the risk factors and symptoms related to stroke. Although this study was limited because data were collected from only one school, the findings suggest a need to educate middle and high school students about stroke risk factors, symptoms and acute interventions.

scholarly journals Racial Variation in Stroke Risk Among Women by Stroke Risk Factors

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 797-804 ◽  
Author(s):  
Monik C. Jiménez ◽  
JoAnn E. Manson ◽  
Nancy R. Cook ◽  
Ichiro Kawachi ◽  
Sylvia Wassertheil-Smoller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Racial Disparities ◽  
White Women ◽  
Stroke Risk ◽  
The United States ◽  
Incidence Rates ◽  
Rate Difference ◽  
Stroke Risk Factors ◽  
Causal Pathway

Background and Purpose— In the United States, black Americans exhibit a greater risk of stroke and burden of stroke risk factors than whites; however, it is unclear whether these stroke risk factors influence stroke risk differently across racial groups. Methods— In total, 126 018 participants of the Women’s Health Initiative (11 389 black and 114 629 white women), free of stroke and coronary heart disease at baseline (1994–1998), were followed through 2010. Participants completed baseline clinical exams with standardized measurements of blood pressure and anthropometrics, medication inventory and self-reported questionnaires on sociodemographics, behaviors/lifestyle, and medical history. Incident total, ischemic and hemorrhagic strokes were updated annually through questionnaires with medical record confirmation. Rate differences (per 100 000 person-years) and hazard ratios (HR) based on multivariable Cox models and were estimated. Results— Over a median of 13 years, 4344 stroke events were observed. Absolute incidence rates were higher in black than white women in each age group. In age-adjusted analyses, the risk of stroke was significantly higher among black compared with white women (HR=1.47, 95% CI, 1.33–1.63); adjustment for stroke risk factors, which may be on the causal pathway, attenuated the estimate. Racial disparities were greatest among women 50 to <60 years (HR=3.48; 95% CI, 2.31–5.26; rate difference =99) and diminished with increasing age (60 to <70 HR=1.80; 95% CI, 1.50–2.16; rate difference =107; ≥70 years: HR=1.26; 95% CI, 1.10–1.43; rate difference =87; P interaction <0.001). Black women 50 to <60 years remained at significantly higher risk than white women after adjustment for stroke risk factors (HR=1.76; 95% CI, 1.09–2.83). Conclusions— There was a moderately greater risk of total stroke among black compared with white women; however, racial disparities were greatest among women aged 50 to <60 years. Interventions targeted at younger black women may provide the greatest benefit in reducing disparities.

Trends in stroke risk factors in the united states

1993 ◽  
Vol 3 (5) ◽  
pp. 550-554 ◽  
Author(s):  
Millicent Higgins ◽  
Thomas Thom
Keyword(s):  
United States ◽  
Risk Factors ◽  
Stroke Risk ◽  
The United States ◽  
Stroke Risk Factors

Abstract TMP59: Interplay of Racial and Geographical Differences in Stroke Type and Risk Factors Among Indigenous West Africans; African Americans and European Americans

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
George Howard ◽  
Mulugeta Gebregziabher ◽  
Fred Sarfo ◽  
Ryan Irvin ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
African Ancestry ◽  
The United States ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Geographical Differences ◽  
European Americans ◽  
Regards Study ◽  
Stroke Type

Introduction: The relative contributions of racial and environmental factors to the higher risk of stroke in people of African ancestry are not clear due to limited opportunities to evaluate stroke type and risk among indigenous Africans, in comparison with Africans in diaspora and their host populations. This knowledge could provide insights into avenues for similar vs. unique approaches to managing stroke risk in Africans. Objective: To compare the pattern of stroke and contribution of vascular risk factors to stroke among indigenous Africans, African Americans and European Americans. Methods: SIREN is a large multicenter case-control study involving several sites in West Africa, the ancestral home of 71% African Americans, whilst REGARDS is a cohort study including African and European Americans in the United States. Stroke diagnosis and type were confirmed using CT or MRI scan. Traditional vascular risk factors were assessed using history, physical examination and laboratory investigations. We compared data from acute stroke cases age≥55 years in SIREN and REGARDS in the distribution of key socio-demographic and clinical risk factors based on harmonized standard definitions. Results: There were 811 stroke subjects in the SIREN population (A) and 452 African Americans (B) and 665 European Americans (C) from the REGARDS study with a progressive increment in mean age of 68.0 ± 9.3, 73.0 ± 8.3 and 76.0 ± 8.3 years respectively, p<0.0001. Hemorrhagic stroke occurred in 291/811 (27.0%), 36/452 (8.0%) and 36/665 (5.4%), in A, B, and C (p < 0.001) respectively. There were significant differences in prevalence of vascular risk factors among the three groups namely hypertension: 92.8%, 82.5% & 64.2%, p<0.01; mean LDL cholesterol (mg/dl): 121±52, 116±32, 110±33 (p< 0.03); cardiac diseases: 12.5%, 25.0% & 31.7% (p< 0.01); sedentary lifestyle:8%, 37.7% and 34.0% (p<0.001); and 2.0%, 18.3% & 14.4% were current smokers in A, B and C respectively (p<0.001). Conclusion: Environmental risk factors such as cigarette smoking may contribute to the higher proportion of ischemic stroke in African-Americans compared to indigenous Africans, while racial factors may contribute to the higher proportion of hypertension among stroke subjects of African ancestry.

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